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SECRET# REQUEST FOR PERSONNEL ACTION1. SERIAL NUMBER0356552. NAME (Last-First-Middle)MATSMIEC, Myroslaw A. ✓3. NATURE OF PERSONNEL ACTION27 Aug 19714. EFFECTIVE DATE REQUESTEDMONTH DAY YEAR05 28 715. CATEGORY OF EMPLOYMENTRegular6. FUNDSX NIE - godony7. FINANCIAL ANALYSIS NO CHARGEABLE8. LEGAL AUTHORITY (Completed by Office of Personnel)1255-53009. ORGANIZATIONAL DESIGNATION10. LOCATION OF OFFICIAL STATIONDDI/NPICDevelopment ComplementWashington, D. C.11. POSITION TITLE12. POSITION NUMBER13. CAREER SERVICE DESIGNATIOND and E Tech9997TP14. CLASSIFICATION SCHEDULE (GS, GL, etc.)15. OCCUPATIONAL SERIES16. GRADE AND STEP17. SALARY CO RATEGS1670.0309 6 $12, 21518. REMARKSPending Disability RetirementLWD-5.28.71Other 5/28/21 P.S.I DUE: 4-29-73PB 6/10/71cc - Securitycc - Payroll18A. SIGNATURE OF REQUESTING OFFICIAL18B. SIGNATURE OF CAREER SERVICE APPROVING OFFICERRobert E. O'Brien, C/PE/OS/KPICSPACE BELOW FOR EXCLUSIVE USE OF THE OFFICE OF PERSONNEL| 19. ACTION CODE                                                                                                                                                         | 20. EMPLOY. CODE              | 21. OFFICE CODING NUMERIC                | 21. OFFICE CODING ALPHABETIC               | 22. STATUS CODE   | 23. NODUPS CODE | 24. NODUPS CODE                                           | 25. DATE OF BIRTH MO. DA.  | 26. DATE OF SPACE MO. DA.   | 27. DATE OF LEAVE MO. DA.  |                                                  |                        || ----------------------------------------------------------------------------------------------------------------------------------------------------------------------- | ----------------------------- | ---------------------------------------- | ------------------------------------------ | ----------------- | --------------- | --------------------------------------------------------- | -------------------------- | --------------------------- | -------------------------- | ------------------------------------------------ | ---------------------- || 38                                                                                                                                                                      | 18                            | 72997 PITC 7312                          |                                            | 300)              |                 |                                                           | 04/30/17                   | 05/02/66                    | 07/02/71                   |                                                  |                        || 28. INI EXPIRES MO. DA.                                                                                                                                                 | 29. SPECIAL RETIREMENT DATA   | 31. SEPARATION DATA CODE                 | 32. CORRECTION, CANCELLATION DATA TYPE     | 33. SECURITY CODE | 34. SEX         | 35. VET. PREFERENCE CODE 0-NONE 1-10 PT. 2-10 PT.         | 36. SERV COMP DATE MO. DA. | 37. LONG COMP. DATE MO. DA. | 38. MEED CATEGORY CODE 14. | 39. FEDERAL HEALTH INSURANCE CODE 0-WAIVER 1-111 | 40. SOCIAL SECURITY NO || :----------------                                                                                                                                                       | :---------------------------- | :---------------------                   | :----------------------------------        | :--------------   | :-----          | :-------------------------------------------------------- | :----------------          | :-------------------        | :----------------------    | :-----------------------------------------       |                        || 05/27/71                                                                                                                                                                |                               |                                          |                                            |                   |                 |                                                           |                            |                             |                            |                                                  |                        || 41. PREVIOUS CIVILIAN GOVERNMENT SERVICE CODE 0-NO PREVIOUS SERVICE 1-NO BREAK IN SERVICE 2-BREAK IN SERVICE (LESS THAN 3 YEARS) 3-BREAK IN SERVICE (MORE THAN 3 YEARS) | 42. LEAVE CAT CODE 1-PS 3-DO  | 43. FEDERAL TAX DATA HOM/STATE CODE 1-MS | 44. STATE TAX DATA FORM EXECUTED CODE 1-FO |                   |                 |                                                           |                            |                             |                            |                                                  |                        |43. POSITION CONTROL CERTIFICATION6-3-71APPROVEDRalph B. PollockActivities Staff OfficerOffice of PersonnelDATE APPROVED28 MAY 1971FORM 1152 USE PREVIOUS EDITION3-67